One of the first, and biggest, challenges as a vet was understanding lameness.
It has been many years since I was a vet student, but I still have a very fixed memory of having to conduct that awkward, and often humiliating, ritual of watching a horse jog to “‘pick out” the lame leg, hoping to get it “right.” It is a memory that remains ingrained in my mind. Down on sound . . . watch the hips . . . watch the head. This ritual is a key element of many equine veterinarians’ practices, and their ability to get it “right,” a measure of their success.
But just as ingrained in my mind as that humiliating ritual in vet school is the day my perspective and approach towards healing lameness completely shifted. After more than 14 years practicing as a “sports medicine” veterinarian, I sat outside on the steps of the Healing Oasis Wellness Center in Sturtevant, Wisconsin, tears rolling down my face. I had just finished my first weekend at animal chiropractic school, and it hit me. I finally understood why it could be so challenging to not just “pick out” the lame leg, but to actually heal that lame leg. You have to treat the rest of the body.
The tears flowed for the horses that I had not been able to heal, the frustrated owners willing to do anything for their animals, and for my profession that perpetuated a paradigm that was archaic and rarely successful over time.
More often than not, lameness is viewed as an isolated event and rarely investigated holistically. Repetitive microtrauma underlies many seemingly acute “single-limb” lameness injuries in which, actually, multiple limbs are involved.
Holistic lameness healing is multifaceted and requires us to examine not just the seemingly “single-limb” lameness injury, but all the coordinated and interdependent systems within the body, activity type and levels, and care management to date. The “single-limb” lameness injury is often a symptom of other underlying issues.
Unfortunately, what is not taught is that getting it “right” only presents you with a starting point for what should be a thorough and comprehensive investigation of potential imbalances in the system. Lameness is just the presenting manifestation of an imbalance or imbalances within the well-coordinated and interdependent systems of the horse’s body. And all too frequently, these imbalances are overlooked.
A perfect example of a common imbalance is high-low syndrome. High-low syndrome refers to an asymmetry in hoof growth with one hoof having a noticeably higher heel or angle than the other. This disparity can be quite dramatic in some horses, and in extreme cases one foot can look flat like a pancake and the other a cube.
The old saying, “no foot, no horse” still stands. Symmetry, or lack thereof, in foot growth and shape is an emergent property that reflects how a horse interacts with gravity, and is directly related to how a horse loads a particular leg and its ability to properly absorb force throughout the body. When an imbalance like high-low syndrome is present, one leg will inevitably absorb more force than others, affecting every single part of the horse’s body. This ripple effect causes compensation patterns to develop that lead to soreness, stress related digestive issues (ulcers), and often a lower threshold of adaptive capacity to life with humans (attitude).
The good news is that these compensation patterns, regardless of their cause, are predictable, and can be easily palpated and managed. It is when these patterns are not identified and well managed that our horses become chronically sore, and move further into dysfunction. These dysfunctional symptoms, like lameness, then become the focus of concern and treatment, creating a frustrating cycle that ignores the underlying imbalance that is the root of the problem.
Treating the injury without treating the underlying imbalance will not produce a horse that heals over time. Treating the imbalance is the only way to distribute the load off the injury which is critical for the horse to maintain healing during movement and to avoid re-injury. This is the foundation behind restorative healing, not quite as simple as “picking a leg” but so much more rewarding.
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